Abstract
Background: To evaluate retinal vessel density (VD) in macular and in peripapillary regions in patients with recent onset of multiple sclerosis, at initial demyelinating event (IDE) and in matched relapsing-remitting multiple sclerosis (RRMS) patients.Methods: We evaluated VD in superficial capillary plexus, deep capillary plexus, choriocapillaris and radial peripapillary capillary plexus in IDE, RRMS patients and in matched healthy controls (HCs) through Optical Coherence Tomography Angiography (OCT-A). Clinical history, including history of optic neuritis, Expanded Disability Status scale and disease duration of patients were collected.Results: Thirty patients (20 with IDE and 10 with RRMS) and 15 HCs were enrolled. IDE patients showed a lower VD in radial peripapillary capillary plexus compared with controls (coeff. β = −3.578; p = 0.002). RRMS patients displayed a lower VD in both superficial capillary plexus and radial peripapillary capillary plexus compared with HCs (coeff. β = −4.955; p = 0.002, and coeff. β = −7.446; p < 0.001, respectively). Furthermore, RRMS patients showed a decreased VD in radial peripapillary capillary plexus compared with IDE patients (coeff. β = −3.868; p = 0.003).Conclusions: Peripapillary region vessel density reduction, revealed through OCT-A, might be considered as an early event in MS, and might be relevant as a biomarker of disease pathology.
Highlights
Multiple sclerosis (MS) is characterized by inflammation, demyelination and axonal loss throughout the central nervous system
We recently described a reduction of retinal vessel density (VD) on optical coherence tomography (OCT)-A in MS compared with controls
At Spectral Domain (SD)-OCT exam, relapsing-remitting MS (RR-MS) patients showed lower ganglion cell complex values compared with initial demyelinating event (IDE) patients (89.54 ± 9.85 vs. 98.61 ± 9.89; p = 0.017) and healthy controls (HCs) (89.54 ± 9.85 vs. 100.2 ± 6.79; p = 0.006)
Summary
Multiple sclerosis (MS) is characterized by inflammation, demyelination and axonal loss throughout the central nervous system. The introduction of the optical coherence tomography (OCT), fast and non-invasive imaging technique, allowed to investigate and monitor the structural retinal damages, in particular the ganglion cell and retinal nerve fiber layers in neurological diseases. Besides the application of advanced MRI techniques such as arterial spin-labeling, optical coherence tomography angiography (OCT-A) offers the unique opportunity to assess integrity of brain vasculature by looking at vascular networks within the retina [6, 7]. Feucht et al recently studied retinal vasculature network in patients with clinically isolated syndrome (CIS), and found vessel rarefaction of superficial and deep retinal plexus only in eyes suffering from previous optic neuritis, while a higher VD in choriocapillaris layer was associated with recent relapses and MRI activity [9]. To evaluate retinal vessel density (VD) in macular and in peripapillary regions in patients with recent onset of multiple sclerosis, at initial demyelinating event (IDE) and in matched relapsing-remitting multiple sclerosis (RRMS) patients
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